Keele Research Repository

Objective To compare the effectiveness of prefabricated foot orthoses to rocker-sole footwear in reducing foot pain in people with first metatarsophalangeal joint osteoarthritis (1(st) MTPJ OA). Design Participants (n=102) with 1(st) MTPJ OA were randomly allocated to receive individualized, prefabricated foot orthoses or rocker-sole footwear. The primary outcome measure was the pain subscale on the Foot Health Status Questionnaire (FHSQ) at 12 weeks. Secondary outcome measures included the function, footwear and general foot health subscales of the FHSQ, the Foot Function Index, severity of pain and stiffness at the 1(st) MTPJ, perception of global improvement, general health status, use of rescue medication and co-interventions to relieve pain, physical activity and the frequency of self-reported adverse events. Results The FHSQ pain subscale scores improved in both groups, but no statistically significant difference between the groups was observed (adjusted mean difference 2.05 points, 95%CI -3.61 to 7.71, p=0.477). However, the footwear group exhibited lower adherence (mean [SD] total hours worn 287 [193] versus 448 [234], p<0.001), were less likely to report global improvement in symptoms (39 versus 62%, relative risk [RR] 0.63, 95% confidence interval [CI] 0.41 to 0.99, p=0.043), and were more likely to experience adverse events (39 versus 16%, RR 2.47, 95%CI 1.12 to 5.44, p=0.024) compared to the orthoses group. Conclusion Prefabricated foot orthoses and rocker-sole footwear are similarly effective at reducing foot pain in people with 1(st) MTPJ OA. However, prefabricated foot orthoses may be the intervention of choice due to greater adherence and fewer associated adverse events. This article is protected by copyright. All rights reserved.